Ultrasound in Obstetrics & Gynecology最新文献

英文中文

Fetal biometry reference ranges derived from prospective twin population and evaluation of adverse perinatal outcome.

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology

Pub Date : 2025-02-27 DOI: 10.1002/uog.29190

P Dicker, S Daly, R M Conroy, F M McAuliffe, M P Geary, J J Morrison, S S Carroll, F D Malone, F M Breathnach

Objectives: Ultrasound-derived estimates of fetal size play an integral role in the prenatal management of twin pregnancy. These biometric measurements are conventionally plotted against singleton standards. We sought to establish fetal growth references for abdominal circumference, head circumference, biparietal diameter, femur diaphysis length and estimated fetal weight (EFW) in twin pregnancy. We also aimed to determine whether the performance of a twin fetal growth reference was superior to a singleton reference in the prediction of adverse perinatal outcome in twin pregnancies.Methods: This was a retrospective analysis of data collected prospectively in the Evaluation of Sonographic Predictors of Restricted growth in Twins (ESPRiT) study, which was conducted at eight academic perinatal centers in Ireland, all with tertiary neonatal intensive care facilities. Only diamniotic twin pregnancies with two live fetuses were eligible for inclusion. Exclusion criteria were monoamnionicity, congenital abnormality, twin-to-twin transfusion syndrome or previable fetal demise (< 24 weeks' gestation). Using serial ultrasound observations, we applied fractional polynomial multilevel models to derive an equation for fetal centile determination. We compared these centiles with published singleton and twin fetal references, with particular focus on the Fetal Medicine Foundation (FMF) references. Using the last ultrasound examinations before delivery, we determined associations between biometric measures and a composite measure of adverse perinatal outcome (intraventricular hemorrhage, periventricular leukomalacia, hypoxic ischemic encephalopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis or perinatal death), neonatal intensive care unit admission, preterm delivery (< 34 weeks) and birth-weight discordance ≥ 25%, based on the varied prevalence of these outcomes. We compared our results with the singleton and twin FMF reference ranges and the twin reference of the Southwest Thames Obstetric Research Collaborative (STORK) study.Results: Among the 948 twin pairs that met the inclusion criteria, 776 (81.9%) dichorionic and 172 (18.1%) monochorionic twin pairs completed the prospective 2-weekly ultrasound surveillance program. Fetal biometric measurements were obtained in 15 274 ultrasound assessments (12 279 in dichorionic and 2995 in monochorionic twin pairs) from serial ultrasound assessments. The median number of ultrasound assessments per pregnancy was 8 (interquartile range, 7-9). Growth trajectories in this cohort were consistent with the FMF and STORK published twin cohorts and notably less consistent with the FMF singleton standard. Compared with the FMF singleton standards, the 50th centiles for twins were greater early in pregnancy and lower later in pregnancy for all biometric measures, in both dichorionic and monochorionic twin pregnancies. This crossover

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引用次数: 0

Increased nuchal translucency thickness and normal chromosomal microarray: Danish nationwide cohort study. 颈部透明层厚度增加和染色体微阵列正常：丹麦全国性队列研究。

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology

Pub Date : 2025-02-27 DOI: 10.1002/uog.29198

K Gadsbøll, N Brix, P Sandager, O B Petersen, A P Souka, K H Nicolaides, I Vogel

Objective: To assess the outcome of pregnancies with increased fetal nuchal translucency (NT) thickness and a normal result from chromosomal microarray (CMA) vs conventional karyotyping.Methods: This was a Danish nationwide registry-based cohort study of all singleton pregnancies seen for combined first-trimester screening between 2008 and 2018. Data on NT thickness and pregnancy outcome were retrieved from the Danish Fetal Medicine Database, whereas data on cytogenetic and molecular karyotypes were retrieved from the Danish Cytogenetic Central Register. Pregnancies were stratified according to NT thickness, and we computed the prevalence of chromosomal aberration, termination of pregnancy (due to non-genetic abnormal findings aside from increased NT), pregnancy loss, major congenital malformation and unaffected live birth (live birth ≥ 24 weeks' gestation with no chromosomal aberration or major congenital malformation diagnosed). The prevalence of the different outcomes was further estimated for pregnancies with increased NT (≥ 3.5 mm) and a normal CMA result. Finally, to assess the impact of CMA compared with conventional karyotyping for increased NT, we compared the prevalence of chromosomal aberrations and each pregnancy outcome between the periods 2008-2012 and 2014-2018 (during which < 3% and > 60%, respectively, of pregnancies with increased NT were examined using CMA).Results: We identified 557 896 pregnancies with a NT measurement for which outcome data were registered. Fetal NT was ≥ 3.5 mm in 3717 (0.7%) pregnancies, of which 3368 (91%) underwent genetic examination. The prevalence of chromosomal aberrations increased significantly with increasing NT thickness, from 21% in pregnancies with NT of 3.5-4.4 mm to 69% in pregnancies with NT ≥ 6.5 mm. Trisomies 21, 18 and 13 accounted for the majority of chromosomal aberrations diagnosed in all subgroups of increased NT (range, 61-87%). In pregnancies with increased NT and a normal CMA result, the prevalence of unaffected live birth decreased significantly from 87% for NT of 3.5-4.4 mm to 29% for NT ≥ 6.5 mm. Increased uptake of CMA during 2014-2018 compared with 2008-2012 slightly increased the detection of submicroscopic aberrations. However, a normal CMA result, compared with a normal result from conventional karyotyping, did not substantially improve the prognosis in pregnancies with increased NT.Conclusions: Our study reaffirms the association between increased NT and chromosomal aberrations. Although CMA improves diagnostic resolution in pregnancies with increased NT, a normal test result does not substantially impact the prevalence of unaffected live births. This highlights the ongoing need for accurate clinical guidance and continued research, especially as whole-genome sequencing is increasingly adopted in prenatal care. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by

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引用次数: 0

Prenatal treatment of axillary cystic lymphatic malformation using rapamycin.

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology

Pub Date : 2025-02-24 DOI: 10.1002/uog.29191

C Mégier, I Mediouni, V Huynh Ho, T Legrand, L Guibaud, A Benachi

引用次数: 0

Twin pregnancy in woman with T-shaped uterus from CUME study.

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology

Pub Date : 2025-02-21 DOI: 10.1002/uog.29196

A Ludwin, M Loboda, L Zaborowska, W P Martins, I Ludwin

引用次数: 0

Advancing fetal cardiac insights: extended implications of iron deficiency anemia on diastolic function and cardiac maturation.

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology

Pub Date : 2025-02-19 DOI: 10.1002/uog.29193

B Li, Y Feng, R Chen

引用次数: 0

Correlation between abnormal umbilical vein flow and birth-weight percentile in low-risk term pregnancies: secondary analysis of multicenter prospective study.

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology

Pub Date : 2025-02-19 DOI: 10.1002/uog.29192

R Ramirez Zegarra, B Valentini, I F Carbone, L Angeli, F Gigli, C Di Ilio, O Barba, O Cassardo, E Ferrazzi, T Ghi

引用次数: 0

Incremental yield of exome sequencing over standard prenatal testing in structurally normal fetuses: systematic review and meta-analysis.

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology

Pub Date : 2025-02-17 DOI: 10.1002/uog.29195

A Sotiriadis, E Demertzidou, A Ververi, E Tsakmaki, C Chatzakis, F Mone

Objective: To critically review the literature and synthesize evidence on the incremental yield of prenatal exome sequencing (PES) in fetuses with an apparently normal phenotype with a normal G-banded karyotype or chromosomal microarray (CMA).

Methods: This systematic review and meta-analysis was conducted using a predetermined protocol and registered with PROSPERO (ID: CRD42024593349). We included observational cohort studies reporting on the incremental yield of PES in fetuses with an apparently normal phenotype and a previously normal G-banded karyotype/CMA. The risk of bias of the included studies was assessed using the Newcastle-Ottawa Scale. The pooled proportion of events was calculated using generalized linear mixed models, using the metaprop function in R version 2.15.1.

Results: Four studies (1916 fetuses) were included in this systematic review and meta-analysis, of which 32 cases had a pathogenic or likely pathogenic variant. The pooled incremental yield of PES in fetuses with an apparently normal phenotype was 1.6% (95% CI, 1.0-2.6%); the majority of variants were de novo within genes associated with autosomal dominant inherited conditions (pooled incremental yield, 0.9% (95% CI, 0.5-1.7%)). Based on the expected severity of the associated disease, the pooled incremental yield was 0.5% (95% CI, 0.1-1.5%) for severe disease and 0.5% (95% CI, 0.2-1.5%) for moderate disease. There were insufficient data to conduct the predefined secondary analyses according to normality of phenotype at birth, variants of uncertain significance and expected age of disease onset.

Conclusion: Pooling data from four studies, we found that 1.6% of phenotypically normal fetuses with a normal G-banded karyotype or CMA may have a pathogenic or likely pathogenic variant identified on PES, most of which occur de novo. The likelihood of a variant being associated with severe disease in such fetuses is 0.5%. However, more research is needed regarding the development of a universal classification of disease severity and the utilization of this evidence in clinical practice. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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引用次数: 0

Prenatal diagnosis of duplicated gallbladder: two-dimensional and three-dimensional ultrasound imaging and reconstruction.

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology

Pub Date : 2025-02-02 DOI: 10.1002/uog.29173

G H A S Pacheco, P T Castro, G Tonni, H Werner, E Araujo Júnior

引用次数: 0

Comprehensive prenatal ultrasound for surgical risk assessment: differentiating placenta accreta spectrum from uterine scar dehiscence for improved clinical decision-making. 用于手术风险评估的产前综合超声波检查：区分胎盘早剥和子宫瘢痕开裂以改进临床决策。

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology

Pub Date : 2025-02-01 Epub Date: 2024-11-07 DOI: 10.1002/uog.29138

R A Aryananda, T K Adu-Bredu

引用次数: 0

Posterior complex: clue for suspicion of partial agenesis of corpus callosum at fetal brain screening. 后复合体：胎儿脑筛查中怀疑胼胝体部分缺失的线索。

IF 6.1 1区医学 Q1 ACOUSTICS

Ultrasound in Obstetrics & Gynecology

Pub Date : 2025-02-01 Epub Date: 2024-10-30 DOI: 10.1002/uog.29136

F Viñals, F Correa

引用次数: 0

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